One of my goals is to spark dialogue. We have been able to do that and it’s been fantastic
Scope of practice, licensing exams and UME single accreditation are huge topics to tackle
I learned a lot from your perspectives !
Let’s keep it going. Here’s a thread of recent papers
@YUNGcoke
I did cataract surgery on a guy in his 30s Tuesday, he was 20/400, on Wednesday one day after surgery was 20/20
Cataract surgery is life changing
Unfortunately every year government (Medicare) + private insurance try to find ways to cut payments or add roadblocks for patients
Nursing is nursing. Medicine is medicine.
Nursing expertise/experience is not transferable to being a doctor, and vice versa.
Totally separate training pathways and models. To be a nurse you go to nursing school, to be a physician you go to medical school.
Both valuable
Lakers traded for Chris Paul. Lebron signed with the Lakers. Paul George, Kawhi Leonard and Anthony Davis all demanded trades to the Lakers. The allure of the Lakers remains the same, but difficult to overcome league wide collusion to block us from acquiring stars
One year ago today I found out I matched into ophthalmology, a highly competitive surgical subspecialty within the field of medicine.
My parents did not graduate from high school.
This country gave us opportunities we couldn’t even dream of.
For those interested we have a 1 year ophthalmology research fellowship (retina heavy) that is
- paid
- in Southern California
- depending on work ethic will have 5-10 publications
- guaranteed interview at our program for residency
DM me for details/applying
Overpriced doctors and other medical providers who can't charge a reasonable rate for their services could be put out of business when new rules against surprise medical bills take effect in January.
Hospitals + clinics forcing patients on to nonphysician providers to cut corners + build profits are immoral
Glad
@NPR
is picking this up
Imagine flight attendants flying planes because they have 10 years experience as a flight attendant
Dermatologists + Plastic Surgeons, medical doctors who graduate the top of their class, have the humility to consult ophthalmology for management of eyelids
Optometrists, who do not attend a day of medical school, believe they can perform lid procedures after a weekend course
I am a medical doctor/physician that went through four years of medical school and am currently completing ACGME residency training
In the US, there are two types of physicians (MD allopathic and DO osteopathic)
Not surprised many journalists too lazy to do a Google search
The proliferation of NPs has not solved and can never, by definition, solve the physician shortage
Only physicians can solve a physician shortage
The opposite has happened. RN shortage is worse, healthcare costs rising, + we have created a second tier of healthcare for the poor
Data shows non physician providers cost the health care system more (more tests, poorer referrals, etc.), do not increase access (work in same populated areas and avoid the same areas others do), and lead to worse outcomes (unless you look at DNP lead sham studies)
Imagine a world where “Pilot Assistants” and “Flight Attendant Practitioners” that took online courses and got certificates were able to fly planes.
That is what NP and PA independent practice is in healthcare.
I am being told
@NationalSOMA
has passed the resolution calling for a single licensing exam.
The resolution and calls for collaboration between the
@TheFSMB
@NBMEnow
and
@NBOME
to work together create a single licensing exam.
No one will be eliminated!
Lets work together
It’s time for the next step
Single licensing exam for all physicians in the US
This period of transition (USMLE + COMLEX pass/fail, single GME) represents a golden opportunity to further unify the house of medicine
Read our commentary in
@JournalofGME
med students interested in ophthalmology!!!
I have an opportunity for you !!
A research year (can be remote) at a top 5 ophthalmology program in the nation.
Paid with benefits
DM me if interested, first come first served.
@honestlybilal
@YoungMDConnect
Last week I did cataract surgery on a patient who went from only sensing light to 20/25 on post op day 1
Prior to surgery she had become depressed due to lack of vision
“No cars, clothes or gifts could mean more than this”
Ophthalmology is the greatest field in medicine
As a resident physician, I would consider it immoral and unjust for me to advocate for independent practice.
Patient safety is more important than my personal interest.
Shocked (not really) that others are willing to put lives at risk for personal gain.
#NoOnAB890
I am cohosting a webinar this Sunday, March 28th with the American Osteopathic Colleges of Surgery, Ophthalmology and Head and Neck Surgery
“Matching Surgical Subspecialties as a DO - Post ACGME Single Accreditation”
Anyone can attend. DM me for link. Also in banner.
Feeling incredibly grateful to so many mentors and supporters. I matched integrated cardiothoracic surgery at
@CedarsCTSurgery
. A huge accomplishment, but not just for me-
@DrTylerWallen
@kc140605
@JeffJacobs215
and so many more made this possible. I’ll work to make them proud!
The “State of US DO” medical students is as strong as it’s ever been.
Here’s the data (2023)
Match Rate
US DO 91.6
US MD 93.7
Residency Placement Rate
US DO 98.1
US MD 97.7
(Thread)
My father was an orphan and immigrated to the US as a child
At 16 he had two jobs, one at KFC and the other at Jack in the Box
At 21 he was married and had me
I will never let his sacrifice and hard work go to waste or take the opportunity the United States gave us for granted
DOs must grind as we come from schools w/ less research, faculty connections but all options are open
My friend (no name DO school) applying competitive surgical subspec and interviewing at Mayo, Cleveland Clinic, Cedars Sinai, Baylor, UWash, etc
DO NOT SELF SELECT OUT
I’m excited to welcome a new set of speakers for my annual low budget high yield webinar
Audience: students from small medical schools with big plans of matching at competitive surgical subspecialties!
Register in advance for this meeting:
Don’t self select out. They told me I could never match ACGME ophthalmology in California. It had only been done once before in our profession, decades earlier
Have a multi pronged plan and trust God. Try your best and live with the results knowing you did everything you could.
Any US grads that have completed a PGY-1 year and are looking for an ophthalmology position?
Would start this July
Program is in east coast
DM me
As with the research position I may not be able to respond to everyone and I apologize beforehand if I don’t get to you
In this time of change
The largest DO student organization in the country passed a resolution calling for a single licensing exam
@jbcarmody
and I advocate for the same in our letter published today
A single licensing exam for DO/MDs
@NBOME
@TheFSMB
First in my family to attend college, and we are going to take it all the way!
Applying for Vitreoretinal Surgery Fellowship this upcoming cycle.
To think I started residency as an innocent boy interested in Cornea.
The Dark Side was simply too tempting.
32% of residency program directors never or seldom interview DOs. Of those who do, 56% require the USMLE for DO applicants.
#AACOMAdvocates
, urge Congress to pass the FAIR Act (H.R. 8850) to ensure GME programs equitably assess and accept DO candidates.
Dr. Harris Ahmed 5/8/2020
My father gave me the opportunities he was not given. This day is entirely his!
Dr. Rafique Ahmed (grandfather, 2nd photo)
Dr. Sufi Siddique Ahmed (great grandfather, 3rd photo).
I never got to meet either of you but hope you are proud
Don’t understand how opposing a policy (taking a stance that the healthcare team works best when we work as a team) and fighting for the poor to maintain access to physicians is interpreted as disrespecting colleagues.
This is an anti intellectual and overly simplistic approach
I hope I’m not in the minority here when I say that physicians should be elevating and respecting our close colleagues who we work shoulder to shoulder with every day.
We created a movement, the AMA, FSMB, NBME, and SOMA all want a single licensing exam for all medical students MD/DO
However the
@NBOME
remains stubborn to the majority
Until then, DO students must keep suffering and take USMLE step 1 and 2 to maximize % of matching residency
The modern resident and medical student are not afraid of advocating for their patients and speaking up about scope.
How did this happen?
Because of increasing examples of bold leadership from attendings across the country.
You inspire and we carry on.
It is my birthday, my wife will deliver any hour now, and I am seeing eye patients in the ED at 2 AM.
I find sacrifice to be beautiful and poetic. Frustration of call ends when you see the patient, vulnerable and in need of help, look to you for help.
One of the unintended consequences many of us outlined. Step one pass fail thus far has devastated DO + MD students from smaller schools
In general, all students feel higher pressure taking Step 2 because the stakes are higher than they have ever been. One exam, all the marbles
Who would be interested in this ?
“Matching Surgical Subspecialties as a DO in the modern era (post ACGME merger)”
a clubhouse or zoom event in the next month or so?
Will gladly organize.
I can have neurosurgery, ophthalmology, Ortho and vascular to start.
Imagine a system where the poor were told their legal counsel would be managed exclusively by paralegals while the rich would maintain full access to JDs with Bar certification.
@Evan_Low
authored AB 2236 that proposes non-physicians perform microsurgical procedures
Evan + his family/friends will keep going to physicians for eye surgeries but he thinks it’s ok for the poor to be operated on by people who never went to medical school
@pppforpatients
If I played any role in you matching directly or indirectly the way you can pay me back is by helping other students in any way you can + prayers for my family !
Won 1st first place for my paper on establishing surgical sub specialty GME in rural and underserved areas !
Using my life experiences and work with patients in the medically underserved Inland Empire to craft responsible policy that will benefit patients
As away rotation season begins remember DO applicants, you should almost focus on places that have never had a DO
You will be surprised at how receptive most places are
And at this point, post unified ACGME, programs/individuals retaining bias should be laughed out the door !
No matter how much it would benefit us financially, a resident physician would never call for independence
Patient safety > self interest
+ no resident would have arrogance to say they can practice w/o full med training
4 yrs med school, USMLE/COMLEX, 3-7 yrs ACGME residency
Crazy week. Thank you to the colleges for this award. I don’t do the work I do for awards but an occasional pat on the back doesn’t hurt.
Yes those are my daughter’s hands haha
2020 was first ever fully integrated single match for US MDs and DOs.
All US MDs and DOs now train under the ACGME.
In 2020,
the DO match rate was 90.7%
MD match rate was 94%
DO placement rate was 99.29% in 2020
Over 90% of former AOA programs transitioned to ACGME
Next frontier that will further destroy healthcare quality and further a two-tiered healthcare system
States allowing IMGs to bypass ACGME residency to practice medicine
Hospital systems want to create another tier of physicians they can use to undercut existing ones
My formal recommendation to DO student remains similar:
take Step 1 and pass so you avoid getting filtered out by a button and you MUST take Step 2 (it is the new life or death all stakes exam)
The idea is to maximize your options!
Many huge wins for
@AMAmedstudents
at this week’s HOD meeting— here’s another one for my
#MedEd
colleagues.
Was honored to testify on behalf of the Council on Medical Education to support this now-adopted policy, calling for a unified licensure exam series for DO & MD students!
New cataract surgeon reflection:
This week I had a postop visit with a patient I did cataract surgery on both eyes
She went from 20/poor to 20/20 OU
She became emotional and prayed for my family. Moments like that is why I wanted ophthalmology
We have to slow down + reflect
Every single temporary measure to allow nonphysicians to practice beyond their scope will be fought to make permanent by midlevel leadership/lobbying in 6 months. Another step towards a 2 tiered healthcare system. For the rich = physician MD/DO. For the poor = nurse or assistant
Very afraid MedTwitter will rage us into another disaster.
There are several THOUSAND more residency positions than there are US medical graduates.
Oversupply and over saturation is NOT the answer.
@NauticalThemed
Sounds silly and ignorant because both MD/DO train under the same accreditation standards (ACGME), but you don’t want to Google basic stuff.
Honored to be selected by the
@AmerMedicalAssn
to serve on their RFS Committee on Legislation/Advocacy.
It is my view that the modern physician must be active in health policy.
US DO placement rate for residency is higher than the US MD rate, per NRMP data.
@TheNRMP
Another piece of evidence confirming this is not the 1950s anymore
I promise you, our strength is our similarities. Elimination of the COMLEX will do wonders for our profession. The students have already spoken and they want it gone.
How can eliminating biases in the residency application process lead to a stronger workforce and better patient outcomes? Learn more in this article published today in the
@JournalofGME
and co-authored by NBOME president
@john_gimpel
@acgme
The endpoint Optometrists seek = Botox and refractive lasers
If organized optometry truly cared about access, they would do diabetic screenings in rural areas. Instead, they angle for “luxury procedures”
These are $ moves after taking hits from contact lens + eyeglass websites
Happy to announce I will be serving
@AOCOOHNS
(DO Society for Ophthalmology + Head and Neck Surgery) as the Council of Residents/Fellows Chair
Will continue to advocate for students from small schools aiming to match surgical fields
+ partner with
@aao_ophth
on advocacy
It is highly deceptive and immoral to confuse patients in clinical settings as to one’s credentials.
In many states it is a felony to misrepresent oneself as a physician.
In academic settings, of course use “Dr”
@danrausa
@ashtonsamos
To group and discuss DOs with IMGs is against the reality of data
IMGs face real discrimination that manifests in a 54% match rate. Our match rate is 91%.
Being looked over by a minority of programs is not the same as systematic suffering that IMGs face
Our veterans and military deserve physician led care
We should not cut corners so that non physicians can practice micro surgical procedures on our heroes after taking a weekend course
Optometrists have tremendous value but their role is not medicine or surgery
YOs! The
#VA
is establishing national standards of practice for nonphysicians. Young ophthalmologists, fellows and attendings who work or have worked at a VA facility should contact the agency and comment on its plans.
#YOInfo
@hasanminhaj
to you it’s a joke.
It’s practical manifestation is patients endangering their lives by refusing physician lead care, thinking there is a genuine/hidden difference between MD/DO/Caribbean trained MDs
ALL ^^^ train under ACGME accredited programs
- a big fan
To any premedical students, always feel free to contact me and let me know how I can help you. I made it here on the backs of many and only through the help of others have I ever accomplished anything. Not everyone is “self made” and it is important to remember that
How can nurses be the answer to a physician shortage? Two separate fields. Different training, education and licensing.
It’s like saying we will solve a pilot shortage with flight attendants
I matched as a first DO in my institution for residency (surgical DJ specialty). Single accreditation has opened opportunities permanently for our grads. Single licensing will take it to a new height.
This kind of mindset is why we have devastating shortages across pediatric specialties. As a parent of two kids it infuriates me to see this sentiment being furthered. People don’t go into pediatrics or Peds specialities because it is financially crippling to do so.
I will never think or say I am “the best” but I have a relentless pursuit of growth and will work like a dog every day.
My parents, mentors and Kobe worked too hard and inspired me too much to not go all in.
Some thoughts:
- Placement rates for US MD and DO graduates remain over 97% as of 2021
- There are more residency positions than there are domestic US grads.
- IMGs, a critical pipeline, are being squeezed out.
- We need targeted GME expansion, not blanket increases
Family Medicine is an outstanding and demanding specialty. I applaud everyone that practices Family Medicine. They are caretakers for communities and have an amazing ability to stay on top of all aspects of medicine.
We will not accept your proposal to create a two tiered healthcare system for patients like those in my home counties of the Inland Empire.
The underserved deserve physician lead care too, not just our well resourced and wealthy communities
That’s exactly why I introduced
#AB890
to allow
#nursepractitioners
to be able to supplement the primary care network without the supervision of a physician - like in 23 other states, the VA and D.C. Florida passed similar bill -March 2020 goes into effect 7/1/20
@CaliforniaNP
@iEyeDoc
Co management in clinic together is not the same as independent laser and eyelid procedure privileges.
Optometrists are an excellent and invaluable asset when practicing in their scope
Part of “discrimination” comes from our substandard licensing exam, IMO.
Plus the data shows that a DO matches better with a USMLE score.
This matter is a lot simpler and can be helped with a single licensing exam.
Appreciate the response but there is no solution offered
Huge point, data shows non physician providers do NOT practice in underserved areas at a higher rate than physicians
BUT even if they did, that would not justify giving the underserved a 2nd tier of care (no physicians) while the rich maintain their physician care
I have been interviewing medical students for our residency program while also interviewing for surgical retina fellowships as an applicant.
Such amazing people go into ophthalmology. Lucky to be part of this profession.
Diagnosed Granulomatosis w/ polyangiitis, internuclear ophthalmoplegia (sent by community as 6th nerve palsy), and central serous chorioretinopathy my last 3 call nights without imaging/labs in the ED
(Confirmed by imaging/labs/attending)
Don’t sleep on history + physical exam!